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这样吃药很不安全

2017-08-08 06:35:51   中国青年网

汪颖

近日,国家食品药品监督管理总局发布《国家药品不良反应监测年度报告(2016年)》(以下简称《报告》)显示,2016年全国药品不良反应监测网络收到《药品不良反应/事件报告表》143万份,较2015年增长了2.3%。药品问题多集中在哪儿?江苏省人民医院药剂科主任药师蒋宇利为大家做了详细的归纳总结,为患者的用药安全提个醒。

沙星类,别自己买来用

《报告》显示,抗感染药的不良反应报告数量最多,其中喹诺酮类药品严重报告比例仅次于头孢类药品,其中又以氟喹诺酮类药品的严重不良反应较多。蒋宇利介绍,临床上常用的氟喹诺酮类药物有诺氟沙星、氧氟沙星、环丙沙星、左氧氟沙星、莫西沙星、加替沙星等。常被用于治疗尿路、肠道、呼吸道以及皮肤软组织、腹腔、骨关节等感染。

成员众多的“沙星家族”在挽救患者生命的同时,若被滥用,也会危害健康。蒋宇利提醒,未成年人、妊娠期、哺乳期以及有沙星类药物过敏史的患者要避免使用沙星类药物;老人和有癫痫或其他中枢神经系统基础疾病患者、肾功能减退患者也应慎用。

生活中很多人一腹泻就吃诺氟沙星,把它当成治疗腹泻的“万能药”。蒋宇利对此表示,该药主要用于治疗泌尿生殖系统感染,虽然也用于胃肠道感染,但腹泻原因很多,只有某些细菌引起的腹泻或急性肠胃炎等患者才建议使用,过度使用会导致胃肠道菌群紊乱。蒋宇利强调,这类药还要注意用量和时间,全身性感染一般使用2周左右;胃肠道感染不超过1周。一定要遵照医嘱,在医生和药品说明书指导下服用。

中西药复方制剂,减少联用

2016年全国药品不良反应监测网络共收到中西药复方制剂的药品不良反应/事件报告1.3万例(占中药不良反应/事件报告的0.52%)。其中新的、严重报告4437例,占34.2%,与单独用药比较,中西药复方制剂合并用药涉及胃肠系统的严重药品不良反应/事件比例较高。

蒋宇利说,中西药复方制剂成分复杂,除中药外还含有西药成分,如解热镇痛药(对乙酰氨基酚、布洛芬等)、镇咳/祛痰(止咳酮、盐酸依普拉酮、氯化铵、盐酸溴己新、盐酸氯喘等)、降糖/降压药(格列本脲、盐酸可乐定等)等。

《报告》显示,国家近年对相关药品发布了不良反应信息通报,提示了珍菊降压片、感冒清片(胶囊)、脑络通胶囊、新复方大青叶片等中西药复方制剂临床应用的安全风险。例如,修订了新复方大青叶片等药物的说明书,要求药品相关企业将新复方大青叶片的风险告知医务人员和患者,并主动开展上市后安全性研究,保障患者的用药安全。国家食品药品监督管理总局建议医务人员应告知患者注意新复方大青叶片可能出现的不良反应,避免长期、过量用药,避免与含有对乙酰氨基酚、异戊巴比妥、咖啡因等成分的药品联合使用。高空作业、驾驶员、精细和危险工种作业者慎用。

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